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First rides after knee surgerypost #1 of 314/12/10 at 6:20amThread StarterI finally got to get back on the road after having my knee operated on a month ago. I started out with a very slow 6 miler ride in the little chainring on Monday, rode around 10 miles with the SLOW group on Wed evening, did 20 on Saturday and bailed on the 30 mile ride on Sunday after 14 miles because my knee was hurting with every pedal stroke. I've got a ways to go to get back where I want to be on the bike, but it sure feels good to be riding again.post #2 of 314/12/10 at 3:39pmThat schedule seems a little ambitious. I hope you recover soon, but if it was me, I'd cut that mileage in half. Good to be motivated, but take it slow and you'll recover faster.
Mikepost #3 of 314/12/10 at 3:50pmpost #4 of 314/12/10 at 6:54pm
id agree with habacomike, peg your doctor for a physical therapist and get a regimind set up for your situation. The PT should be able to set one up specific to your needs and goals so you'll risk less and gain more.
Good luck, don't ignore pain ... it is there for feedback but i am a quite cautious person.
ps, the PT might also suggest a diet adj or modification that may help with repair ..
post #5 of 314/12/10 at 7:54pmThe other thing you'll want done is to have your bike refitted ASAP. Post-surgery, the dynamics, flexibility, strength and other variables can change. While the pains you describe likely stem from overuse at this stage in recovery, it would be worth your while to go to a well-reputed bike fitter to see if your setup needs tweaking.
Not a doctor, just my $0.02, but being a skier and a cyclist I've been through this injury/PT/refit thing before.post #6 of 314/13/10 at 6:03amThread StarterGood advise all, I tend to agree that maybe that was too much too soon, I think this week it will be more shorter rides.
I had the meniscus repaired and some the bones shaved down to get rid of the arthritis. I have been working with a PT since the surgery getting the knee/leg stronger and working on flexibility.
Songfta, I have already done exactly what you suggested, interestingly, the guy raised my seat by over an inch and moved me forward by almost an inch and a half. Interesting, because when I bought my bike (a Cervelo Soloist), the guy that did the original fitting was suppose to be one of the best around. Go figure. All I know is it feels like a much better fit now and I am able to get much lower and flatter on the bike.post #7 of 314/13/10 at 6:27ampost #8 of 314/14/10 at 12:49pmQuote:
The level of conditioning changes the optimal fit. Heck, the ProTour riders will change their fit over the season, without even having been injured and sidelined.post #9 of 314/15/10 at 4:29pmThread StarterI escorted one of the new riders on our club TT last night and did one lap (1.6 miles) at full speed, which for me is not really all that fast, during the warm up. It felt great.
As a side note, one of our 13 year old boys did the 3.2 mile TT in a hair under 29 MPH. I didn't even go that fast on the downhill stretch.post #10 of 314/15/10 at 4:38pmThat's great! Keep at it.
I doubt I could carry 29 mph on a 3.2 mile flat course. It seems like a worthy goal, though. My cycling coach won the State TT championships last year with a 29 mph ride. I'm just in awe of that.
Mikepost #11 of 314/15/10 at 6:25pmThread StarterThis kid is unbelievable. He reminds me of Miguel Indurain, long legged and rail thin. He has been crushing the Cat 3 races all spring. The thing that amazes me most is not so much his physical prowess, which is amazing, but his race presence. You can watch him looking around the whole race, sizing up the field and in the last lap or two he knows where he needs to be to contest the outcome of the race. That is something that most adults still haven't figured out.post #12 of 314/19/11 at 12:38pm
You guys are inspirational and you all rock! I was sooooo looking forward to the beginning of biking season here in the Northern Virginia area, that I forgot to look before I fell (long story), ended up completing disconnecting my quad from my knee, and had surgery 3 weeks later (March 21) to get it straightened out. Anyway, the surgeon reattached the tendon, only immobilized my leg for 10 days, then put me on a hinged brace (plus a crutch) and into PT where, on the first day, they drove my ROM to 60 degrees and began isometric and stretching exercises. Now, on April 19, I've got a painless ROM at 95 degrees, my walking has improved (but the leg is still very weak), and I'm looking forward to getting back on a stationary bike this week, under the doctor's PT prescription. It hurts, hurts, HURTS especially at night, but I'm not willing to give up on my dream of doing a flat 50 miles on Maryland's eastern shore this August and then resuming normal biking commuting and weekend rides with my buds in 2012. While my friends are riding hard rides in Virginia's fantastically beautiful wine and Blue Ridge regions, I'm just cranking on PT, waiting for the day I can rejoin them. You folks offer me hope, when so many people around me say things like, "Well, I guess your extreme biking days are over..."; "Well, I guess you'll need to slow down...", etc. Or, per Joannie Mitchell, "You don't know what you got til it's gone." Thanks and I look forward to participating in the back/forth replies.post #13 of 314/19/11 at 6:59pmInteresting that this thread was revived today. I had acl reconstruction surgery 5 weeks ago tomorrow, and today was my first real ride outdoors. I had to buy a new road bike, as the pt won't let me ride in clip less pedals for another 10 weeks, and it's kinda mandatory to use clip less pedals on my high racer recumbent. So I test rode a bunch of bikes Saturday and Sunday, and settled on a Salsa Cassaroll. I was thinking of going for a Ritchey Breakaway cross, but I couldn't find one to ride and what led me into recumbency in the first place was inability to get my head into position on a diamond frame.
So, today was my first outdoor quasi training ride. It's quasi as I'm under strict instruction to keep my power down, my position seated, and my route flat. So, I did what I usually consider my flat time trial route, about 17 miles, only about 800 feet of climbing, a route that I usually break 20 mph on and have maintained 22.3 mph on. It rained hard last night, and the temp was in the low 40's this am. I thought about going to the gym and riding the stationary bike again, but that would be wussing out. As I rode, the wind built until it was around 15 mph at the end of the ride.
I was pretty disappointed in my ride time. Only about 14.5 mph. But then again, I'm less than 5 weeks out from surgery, I've been injured for the last 7 weeks, I've definitely lost conditioning over that time despite the amount of time in the gym, and I really haven't riden a diamond frame in more than 30 years.
So, not a bad first day, all in all. I've got lots of work to do on my rehab and to regain and enhance my physical condition. I've also come to the reality that I'll have to abandon some of my pre- injury plans. The Bicycle Tour of Colorado is out this year, and I'll likely not be able to ride the Buena Vista century, but perhaps might be able to do a metric. I'm still holding out hope for the Elephant Rockcentury the week after Memorial Day.
So, I now need to set new goals for this cycling season. I still have that sub 5 hour century goal in September as the official event was cancelled last fall because of the wildfires. I've been thinking about the Rocky Mountain Bike Tour in August, but it's almost entirely the same route I rode in the btc two years ago. So, if you've got some ideas of stretch goals in the post July timeframe, serve em up!
Mikepost #14 of 314/19/11 at 7:04pmpost #15 of 314/20/11 at 8:13pmpost #16 of 314/21/11 at 9:47pmpost #17 of 314/25/11 at 6:15am
Riding in any form after an ACL repair is really great. Don't ever separate a quad, however. You spend 4 weeks just getting your knee's ROM from 60 to 95, and then you are allowed to do partial rotations on a stationary bike, another 4 - 6 weeks to repair atrophied muscles, and riding slow and in the flats maybe, just maybe, after 4 - 5 months, assuming the physician doesn't totally freak out and tell you to never ride again (happened to a friend of mine). Best wishes to you.post #18 of 314/25/11 at 9:09pm
Yea, I can't complain. I was able to start riding outside at 4.5 weeks post op. I made my third ride outdoors yesterday; unfortunately, I crashed. Fortunately, I did no damage to the knee.
I need to work on those bike handling skills. Particularly cornering with those @#!$ platform pedals.
Mikepost #19 of 315/1/11 at 12:33pmQuote:Originally Posted by habacomike
Interesting that this thread was revived today. I had acl reconstruction surgery 5 weeks ago tomorrow, and today was my first real ride outdoors. I had to buy a new road bike, as the pt won't let me ride in clip less pedals for another 10 weeks, and it's kinda mandatory to use clip less pedals on my high racer recumbent.
Interestingly, my surgeon gave me the green light to road ride with clipless pedals and no brace, 3 1/2 weeks after ACL surgery....this after telling me to wear the brace even when I go to check the mail. He said that as an experienced rider, he was less concerned that twisting out of the pedals than a less experienced rider. I'm not confident enough to ride without the brace, yet. So far, unclipping hasn't felt bad.
Edited by Alpinord - 5/2/11 at 9:53ampost #20 of 315/2/11 at 8:55am
Very interesting the differences in our restrictions, Terry. I've been out of the brace since week 2.5. The surgeon did want me to wear it if it was snowy or icy outside, but otherwise not. I rode on the stationary bike for the first week in the brace, but afterward I've been out of it. Of course, the issue is not the stationary bike, nor the flexion and extension on the bike itself, but what happens if you crash.
Which is exactly what happened to me a week ago Sunday. As I'm not familiar with a diamond frame bike (I ride a carbon fiber recumbent) nor with platform pedals, I pedaled out in a corner, put the bike on the pedal, and crashed hard. I've got a pretty good hip pointer. It's a bit painful, but the pain is starting to subside. It hasn't kept me off of the bike, though. I did back to back 2 hour rides this weekend. Next weekend, I plan for 2.5-3 hour rides. No swelling yet.
Keep up your spirits, and keep the rubber side down.
Mikepost #21 of 315/2/11 at 10:02am
I'm thinking of getting training wheels for the bikes
and outriggers for my skis since I am very capable of crashing for no apparent reason.
I've been out of the brace since about the same period for very controlled tasks and around the house. Out walking the dog without one was near disaster when I made a reactive move. My new Ossur multi-spot brace is super lightweight and easily accommodates activities. So wearing it even when you know you are fine isn't a huge deal to avoid those thoughtless quick moves or little slips when you are focused on the task at hand or elsewhere versus being uber careful.
The above mentality has in mind that as I understand it, even though your knee feels better and better, the new ACL is actually less and less so. This is due to the fact that it takes 3 months or so for your body to establish a blood supply to the essentially dead tendon (hamstring) as it transforms into the new ligament. In theory, your new ACL is most vulnerable at around 3 months and then needs to ramp up again in strength through six months before you can rely on it to perform as good or better than the original.
Edited by Alpinord - 5/2/11 at 10:16ampost #22 of 315/2/11 at 6:32pmMy buddy tried to convince me to buy training wheels so I would be able to train for the bicycle tour of Colorado. I demurred and my knee is feeling the weekend, lifting today, and the stability drills. I may be able to accomplish my plan this weekend of riding 40-50 milers back to back, but the Buena Vista century in 3 weeks is looking like a long shot. Perhaps I'll be able to do the metric.
My pt, an avid cyclist as well who both rode 2 btc's with me and had acl reconstruction surgery a week before me, also indicated the issue of the vulnerability of the acl graft. She indicated that the weakest point is about 6 weeks, with it building strength to 3 months. Btw, she is also reduced to platform pedals. I'm looking forward to gradu.sting to real pedals, comfort, and speed all embedded in my recumbent.
I moved my powertap wheel over to the new bike. My power is definitely down, but not down by as much as I wouldve expected given the length of my rehab. I bought a neuromuscular stimulator to do the quad set/leg raise exercises right after surgery (bought second hand off of craigslist) and hit the bike pretty hard right after surgery; i think this definitely helped maintain much of my conditionng. I think I'll be able to regain my strength relatively quickly. The issue is how much stress my grafts can tolerate
It's play it by ear time. I am, however, returning to training with my cycling coach next week, most likely.
Mikepost #23 of 315/2/11 at 8:03pmpost #24 of 315/3/11 at 12:18pm
It would be nice to have a warm day without wind or rain. I wonder if they will be able to do the usual century course; it seems there is still quite a bit of snow in the high country and the Turquoise Lake Road is pretty late to open. I guess we'll see what happens.
Hope to see you there, Dave.
Mikepost #25 of 315/12/11 at 10:46am
An update: My doctor has allowed me to go to full ROM and up to 35 minutes on a stationary bike with continous "upgrades" to harder levels, depending on how I feel (not according to any formula). He's not freaking out over my riding again; he's saying flat riding on a road bike 4 - 5 months out from surgery, or for me, July - August. Yeayy! Babysteps, people, babysteps. And after I hire a trainer this winter to fully restore my leg and then some, by next summer, with luck, it's back to the hilly rides with my buds in the beautiful VA horsecountry. I never knew how much I loved biking until it was gone. There's a lesson in all of this.post #26 of 315/12/11 at 1:32pm
Yesterday was 8 weeks post op. I got my first training plan from my cycling coach this week. It has two weekday 1.5 hour rides, and two weekend rides of 2-3 hours. Seems doable.
Last weekend, I rode my first 3 hour ride on Saturday, about 50 miles. My knee did swell a bit, so I cut the Sunday ride to a bit under 2 hours, 30 miles. In general, the knee feels ok, although I do seem to feel more "tweaks" in it than I did a few weeks ago.
I'm also doing a couple of days of strength training a week. I'm pressing about 230 with both legs, and 85 with the one bad leg (about 60 reps). I also restarted straight leg lifts, but only with 40 pounds. Since I had a hamstring graft, it's made me a little bit sore.I think I'm rebuilding strength.
Next weekend, I'm riding a metric century. Two weeks after that, I may attempt my first real century, but we'll see how the training goes between here and there.
I see the PT tomorrow. She was on vacation last week, so she may not be on board with all of this...
Mikepost #27 of 316/14/11 at 5:34am
Habacomike: I am being very cautious getting back on my bike. I can do 40 minutes on a trainer or stationary bike. My plans are to begin biking again on July 14 (yes, Bastille Day, appropriately enough), but very slowly...practicing mounting and dismounting and going slow in a parking lot before I get on the road. My urban commute into DC naturally features a few mounts and dismounts. Has that caused you any problems as you first began reiding again? And when were you able to ride out of the seat (another concern of mine)? Any help or info would be greatly appreciated. Erniepost #28 of 316/14/11 at 7:32am
Ernie, I'm guessing that your injury was a quad repair? You may have different restrictions than I do as a result, but here's what's going on with me.
I did my first metric century of the season three weeks ago. It went fine, and I rode 40 miles the day after. A bit of swelling, but no big deal. I had been considering riding the Elephant Rock century a week ago Sunday, but because I was not able to train memorial day weekend at the level that would test my ability to ride long (it was my daughter's graduation from college), I opted for the metric. ERock is a relatively hilly route anyway, and the outcome again was okay, but with a bit of swelling still. This past weekend, I seriously ramped the load, with a 30 mile ride on Friday, a Metric on Saturday with the first moderate climb of the season (to Jamestown in Lefthand Canyon), and a 70 mile flat ride on Sunday. Yesterday I saw the PT after doing my strength training and a 30 minute recovery ride. My extension was inhibited by soft tissue inflamation and swelling.
This morning, I had hoped to ride my 30 mile tempo ride, but my knee is swollen. So, I'm sitting here composing this response to you instead. Not that I don't like sharing info, but I'd rather be on the bike. I did ride about 190 miles last week, which was week 12 after surgery. I'm doing pretty well in my recovery.
So, as to limitations. I was not allowed to ride in clipless pedals until a week ago. I didn't really find that it inhibited me too much, other than taking a nasty spill, obtaining a deep hip pointer, and getting a bump on my elbow that is finally about to go away 6 weeks after the crash. Stupid me; I didn't have my inside pedal up, drug it in a hard corner, and took a spill. But other than that, mounting and dismounting hasn't been a problem.
If I were you, I'd be careful about resuming cycling with clipless pedals at first, particularly if you are primarily riding in an urban environment. Yesterday, I was riding through our downtown area (all three blocks of it) and there was so much going on to react to, I don't think you'd want to be in an emergency situation with a injury where you might have to eject from the pedals or take a tumble. But I'd discuss it with your PT. My PT has the advantage of also being a serious cyclist who underwent ACL reconstruction a week or two before me. So she has kept me on the straight and narrow regarding the bike, but also let me resume using clipless pedals a bit before the protocol would normally suggest.
Also, I'm still not allowed to stand while pedalling. It just puts too much load on the knee. That won't be much of an issue for me anylonger as I've know been able to revert to my recumbent, with an immediate 2 mph boost in my average speed.
What's really important is to listen to your body. Don't overstress it. Remember the training adage "train hard, but rest harder." And discuss your goals, objectives, and limitations with your PT. He/she will have some good advice for you.
Best of luck,
Mikepost #29 of 316/14/11 at 12:55pm
Mike - Cool and thanks for the advice. I did detach my quad.
I don't much care what my PT person says, because I'm going to be hyper-careful and also because she's not a cyclist. I'm not riding on the roads or into the city until I have 100 percent confidence I can do so competently. That means riding in the small gear in the parking lot for quite awhile and/or on trails when they are quiet. I don't think I would have any issues unclipping, due to the lack of tension in the SPDs I use, but I shall see. You have made a lot of sense to me, so I'm going to be hyper careful about this.
Erniepost #30 of 317/19/11 at 10:51am
Updating my status: Injury (fall and resulting quad tendon detachment) - 2/28/11. Surgery to repair quad - 3/21/11. Begin and end PT: 4/1/11 - 7/6/11. First bike ride: a very slow 8 miles on 7/4/11. Since then, I've made progress in the biking sense. 7/14/11, 7/15/11 - Commutes to work in downtown Washington, DC from "in-close" lot - 18 miles round trip. Yesterday, 7/18/11: Commute to work from further out - 30 miles round trip. Speeds have increased from a pitiful 12.5 mph to more than 13.5 mph. The only downside of biking that I see now is that it loosens up the tracking in my knee, since my patellar tendon is still not very strong, and my hamstring gets stiff after the rides. As a result, I sometimes get that weak legged feeling and phenomenon. I am continuing "PT" on my own in the gym with full leg extensions, leg presses, knee curls, abduction/adduction exercises, squats, etc. I am wanting to re-establish some kind of jogging routine, but my leg doesn't feel stable enough to do that, even though I can walk 5 - 6 miles. My next step, in late August, will be to begin working with a trainer to get full leg functionality again.
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